Robert Reich’s Pie in the Sky Push for Universal Medicare

Robert Reich’s Pie in the Sky Push for Universal Medicare

Robert Reich, the former Secretary of Labor under President Clinton, has a column out pushing universal Medicare that fundamentally fails to grapple with reality in making the case. He admits Medicare is breaking the bank and then chides President Obama for relying on the (unnamed) Medicare Independent Advisory Board to reduce costs. From “Medicare Isn’t the Problem, It’s the Solution:”

President Obama on the other hand, wants an independent commission to recommend cuts if the yearly costs of Medicare rise half a percent faster than the national economy. That’s better but still assumes Medicare costs are the problem. They’re not.

It doesn’t get much better. He chides doctors for ordering needless tests to make money:

The reason: Here, doctors and hospitals have every incentive to spend on unnecessary tests, drugs and procedures. But they have little incentive to keep people healthy. You have lower back pain? Almost 95 percent of such cases are best relieved through physical therapy. But doctors and hospitals routinely do expensive MRIs and then refer patients to orthopedic surgeons who often do even more costly surgery. Why? There’s not much money in physical therapy.

Shades of President Obama’s demagoguery when pushing Obamacare, accusing pediatricians of ordering needless tonsillectomies! Let’s face facts here: Most doctors don’t order these tests for venal reasons. It is to protect their wallets from malpractice devastation–e.g., defensive medicine–which goes completely unmentioned by Reich.

He then suggests that the expense of rehospitalization could be reduced by having a nurse visit the home of every acute hospital patient after release. I like the idea–in an ideal world–but I really don’t think that would reduce costs overall. I mean millions and millions of private nurse visits a year? However, if such a benefit would actually reduce costs, the private sector would embrace it. If not, then Reich has wandered off his cost cutting meme and into the land of ever expanding benefits–which breaks banks.

He then writes:

Allow Medicare – and its poor cousin, Medicaid – to use their huge bargaining leverage over doctors and hospitals to change the incentives driving the health care system. Instead of reimbursing doctors and hospitals for the costly tests, drugs and procedures, pay them for keeping people healthy.

Pie in the sky. HMOs were supposed to do that, and it just doesn’t reap the benefits hoped. Moreover, doctors aren’t dictators. They can tell people not to smoke or overeat, but how do they force them? They can tell people not to have 15 sexual partners a year, but that won’t keep them out of multiple beds. Besides, our society is aging. Paying doctors to keep them healthy can’t overrule biology.

With the exception of the administrative cost issue, Robert Reich’s column is profoundly unserious. By pretending that universal Medicare would be a magic wand, and supporting his thesis with cliche demagoguery, the column disappoints.

The news that FBI deputy director Andrew McCabe was fired hours before qualifying for retirement with full benefits somehow grew over the weekend into a false impression that the career FBI agent was stripped of his pension altogether.
[jwplayer GlHOavPa-wKJ9CRQU]
Members of the media remarked that McCabe ...
Read More

Representative Adam Schiff (D., Calif.) bucked his party on President Trump's firing of FBI deputy director Andrew McCabe, remarking that his dismissal may have been "justified."
“You know, his firing may be justified,” the top Democrat on the House Intelligence Committee said on ABC’s This Week. ...
Read More

Labels multiply in supermarkets faster than salmonella at a convenience-store sushi bar. It’s important to keep up; we should all be well-informed eaters. But the onslaught of clean food, natural products, sustainably produced, gluten free, butterflies everywhere, and GMO-free sea salt are just too much. The ...
Read More

It can be hard to keep one’s wits about oneself during the Age of Trump. Our president is like the ringmaster of a circus, and the American people are his enthralled spectators. It seems as if we cannot get enough. Love him or hate him, he remains at the center of our public consciousness.
It is hard to ...
Read More

The “free college” movement, fueled to a large degree by Bernie Sanders during his 2016 presidential bid, is a response to concerns about increasing college-tuition rates, concomitant stagnation in state and federal grants, and a corresponding student-loan debt load that has ballooned to roughly $1.4 ...
Read More

The use of assassination raises two difficult sets of questions.
First: Is it effective? Can the elimination of an individual significantly change the course of history? Make the world a safer place? Save the lives of other human beings?
Second: Is it morally and legally justified? Is it ethically and ...
Read More

An unforced error from a Vatican communications office the other day drove me a little something like crazy. The nature of the unforced error is that it is wholly unnecessary and typically distracting. And so it was.
Days before, as the fifth anniversary of Pope Francis’s election as pope was approaching, a ...
Read More

Of all the abrupt comings and goings in this administration, the dismissal of Rex Tillerson is undoubtedly the most important — maybe one of the most important firings since Harry Truman fired Douglas MacArthur during the Korean War.
By dismissing MacArthur, Truman drew a firm line between military and ...
Read More